Revenue Integrity Analyst - BHS Management Services

Berkshire Health Systems - Pittsfield, MA

Full-time - Mid Level

Pittsfield, MA

Hospitals

About the position

The Revenue Integrity Analyst is responsible for auditing charge capture data and monitoring revenue functions to ensure compliance with government regulations and coding guidelines. This role involves educating staff on coding definitions and documentation, assisting operational departments with coding corrections, and analyzing billing denials to improve revenue reimbursement. The analyst will also collaborate with the billing department and senior chargemaster analyst to ensure effective charge capture and minimize late charge rework.

Responsibilities

• Audit and examine charge capture data and revenue monitoring functions.
• Ensure proper charge capture based on government regulations and coding guidelines.
• Educate clinical and operational staff on CPT/HCPC definitions and documentation regulations.
• Assist operational departments with coding, charging, and documentation issues.
• Review billing denials focused on documentation and coding to identify improvement opportunities.
• Analyze paid versus expected payments to enhance revenue reimbursement.
• Monitor the timeliness of charge capture to minimize late charge rework.

Requirements

• Minimum of 3 years working in a revenue cycle/revenue analyst role.
• Knowledge of inpatient and outpatient billing practices, coding guidelines, and CMS Medicare reimbursement methodology.
• Strong quantitative, analytical, and organizational skills.
• Experience with Expanse and/or Meditech software.
• Exceptional communication skills, both written and verbal.
• Proficiency with Microsoft Office, including Excel, Word, and Outlook.

Nice-to-haves

• Ability to handle stressful situations calmly and rationally.
• Self-motivated with problem-solving skills.
• Experience working in a team-oriented, collaborative environment.